Individual
SHIFRA CENSOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
111 HARVARD ST, LAKEWOOD, NJ 08701-1954
(917) 757-2077
Mailing address
111 HARVARD ST, LAKEWOOD, NJ 08701-1954
(917) 757-2077
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00509700
NJ
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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